LOW BLOOD-PRESSURE AND DEPRESSION IN OLDER MEN - A POPULATION-BASED STUDY

Objective-To determine if an association exists between low blood pres sure and depressive symptoms in older men living in the community. Des ign-Cross sectional, population based study. Setting-Town of Rancho Be rnardo, California, United States. Subjects-846 men aged 60-89 years. Comparisons between hypotensive, normotensive, and hypertensive groups were limited to 594 men not taking drugs for hypertension. Main outco me measures-Mean scores on Beck depression inventory and prevalence of scores greater than or equal to 13. n Results-Men with diastolic bloo d pressure <75 mm Hg had significantly higher depression scores (mean scores 6.35 v 4.96; P < 0.001) and more categorical depression (7.6% v 1.8% with scores greater than or equal to 13; P < 0.01) than men with diastolic blood pressure levels between 75 and 85 mm Hg. Men with dia stolic blood pressure levels > 85 mm Hg had higher depression scores t han men with intermediate blood pressure levels (mean scores 5.85 v 4. 96; P < 0.05). Men with diastolic hypotension scored significantly hig her on both affective and somatic item subscales of the Beck depressio n inventory and on individual measures of fatigue, pessimism, sadness, loss of appetite, weight loss, and preoccupation with health. Low dia stolic blood pressure was a significant predictor of both mean depress ion score and prevalence of categorical depression, independent of age and change in weight since the baseline visit. The presence of severa l chronic diseases was associated with depressed mood and higher blood pressure but not with low blood pressure. Conclusion-The association of relatively low diastolic blood pressure with higher depressive symp tom scores and rates of categorical depression was independent of age or weight loss. Since fatigue is a prominent symptom of depression, an y association of low blood pressure with fatigue could reflect depress ive disorders or clinically important depression.